Author/Authors :
Baydar, B Türkiye Yüksek İhtisas Hastanesi - Gastroenteroloji Cerrahisi, Turkey , Kayaalp, C Türkiye Yüksek İhtisas Hastanesi - Gastroenteroloji Cerrahisi, Turkey , Oruğ, T Türkiye Yüksek İhtisas Hastanesi - Gastroenteroloji Cerrahisi, Turkey , Demirbağ, A E Türkiye Yüksek İhtisas Hastanesi - Gastroenteroloji Cerrahisi, Turkey , Atalay, F Türkiye Yüksek İhtisas Hastanesi - Gastroenteroloji Cerrahisi, Turkey
Abstract :
Aim:To follow the drain amylase levels, to determine and to classify the relationship between drain amylase levels and pancreaticojejunostomy anastomose leaks in Whipple procedure.Material and Methods:Data from 187 patients on which a pancreaticoduodenectomy was performed were analyzed retrospectively between April 1999 and February 2006. Age, sex, symptoms, preoperative drainage procedures, the location of tumour, pathologic diagnose, additional surgical procedures during the operation, PJ anastomose technic, morbidity, hospital mortality, existence of pancreatic anastomose leak and fistula, the level of pancreatic drain amylase at first 7 days, the relationship of these variables with pancreatic anastomose leaks and the importance in determining anastomotic leaks were all examined. The collected data were evaluated as retropective cohort study. Results:One hundred and twenty of the cases studied were male, and 67 were female. The mean age was 57.39±11.421 years. The most applicable symptoms were jaundice (64,7%) and abdominal pain (29,9%). The morbidity and mortality were 59,4% and 11,2%, respectively. According to the classification done in the study, 37,4 patients had normal drain amylase values, 20,9% had biochemical leak, 21,4% had minor leak, 10,7% had major leak, and 9,6% had pancreatic fistula.Conclusion:A new classification was determined which classified the pancreatic anastomotic leaks together with the levels of drain amylase, clinic, laboratory and radiologic data in the patients on which pancreaticoduodenectomy were performed.
